© Te Author 2016. Published by Oxford University Press on behalf of the British Occupational Hygiene Society. • 619 Compliance with the Use of Medical and Cloth Masks Among Healthcare Workers in Vietnam Abrar Ahmad Chughtai 1 *, Holly Seale 1 , Tam Chi Dung 2 , Andrew Hayen 1 , Bayzidur Rahman 1 and C. Raina MacIntyre 1 1.School of Public Health and Community Medicine, UNSW Medicine, University of New South Wales, Sydney, Australia; 2.National Institute of Hygiene and Epidemiology (NIHE), Hanoi, Vietnam *Author to whom correspondence should be addressed. Tel: +61-(2)-9385 1009; fax: +61-(2)-9313 6185; e-mail: abrar.chughtai@unsw.edu.au Submited 23 June 2015; revised 18 January 2016; revised version accepted 19 January 2016. ABSTRACT Background: Masks are ofen worn in healthcare setings to prevent the spread of infection from health- care workers (HCWs) to patients. Masks are also used to protect the employee from patient-generated infectious organisms but poor compliance can reduce efcacy. Te aim of this study was to examine the factors infuencing compliance with the use of medical and cloth masks amongst hospital HCWs. Methods: HCWs compliance with the use of medical and cloth masks was measured over a 4-week period in a randomized controlled trial in Vietnam. HCWs were instructed to record their daily activi- ties in diary cards. Demographic, clinical, and diary card data were used to determine the predictors of compliance and the relationship of compliance with infection outcomes. Results: Compliance rates for both medical and cloth masks decreased during the 4 weeks: medical mask use decreased from 77 to 68% (P < 0.001) and cloth masks from 78 to 69% (P < 0.001). Te presence of adverse events (adjusted RR 0.90, 95% CI 0.85–0.95), and performing aerosol-generating procedures (adjusted RR 0.78, 95% CI 0.73–0.82) were negatively associated with compliance, while contact with febrile respiratory illness patients was positively associated (adjusted RR 1.14, 95% CI 1.07–1.20). Being compliant with medical or cloth masks use (average use ≥70% of working time) was not associated with clinical respiratory illness, infuenza-like illness, and laboratory-confrmed viral infection. Conclusion: Understanding the factors that afect compliance is important for the occupational health and safety of HCWs. New strategies and tools should be developed to increase compliance of HCWs. Te presence of adverse events such as discomfort and breathing problems may be the main reasons for the low compliance with mask use and further studies should be conducted to improve the design/ material of masks to improve comfort for the wearer. KEYWORDS: cloth masks; compliance; healthcare workers; masks; medical masks; respiratory infections BACKGROUND It is well documented that compared to the general population, hospital healthcare workers (HCWs) are at increased risk of acquiring various nosocomial res- piratory infections (Bellei et al. 2007; Macintyre et al. 2014b ). In addition, studies have shown that HCWs Ann. Occup. Hyg., 2016, Vol. 60, No. 5, 619–630 doi:10.1093/annhyg/mew008 Advance Access publication 15 March 2016 Downloaded from https://academic.oup.com/annweh/article/60/5/619/2196184 by guest on 06 July 2022